Physician Compare National (NPI:1932463940)

HEALTHCARE PROVIDER: BRANDI DAWN MILLER D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1932463940
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072747344
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181012000205
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MILLER
	Individual professional last name
Provider First Name	BRANDI
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MERCY CLINIC SPRINGFIELD COMMUNITIES
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7416865845
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	932
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1965 S FREMONT AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	370 MC UROLOGY S FREMONT
	Group Practice or individual's line 2 address
City	SPRINGFIELD
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	658042284
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4178200300
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230273
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	DETROIT RECEIVING HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230024
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SINAI-GRACE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230104
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HARPER UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	260065
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MERCY HOSPITAL SPRINGFIELD
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y